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{{PBI|Cystoisospora belli}}
===Epiglottitis===
:* 1. '''Cystoisospora belli treatment'''<ref>{{cite web | title = CDC - Cystoisosporiasis | url = http://www.cdc.gov/parasites/cystoisospora/health_professionals/index.html }}</ref>
*Epiglottitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
::* 1.1 '''Immunocompetent hosts'''
:*Pediatrics
:::* In the immunocompetent hosts, symptoms of Cystoisospora infection are usually self-limited.
::*Preferred regimen (1): [[Cefotaxime]] 50 mg/kg IV q8h
:::* Antimicrobial therapy to immunocompetent patients may be considered if symptoms do not start to resolve spontaneously after 5 to 7 days (depending upon severity)
::*Preferred regimen (2): [[Ceftriaxone]] 50–75 mg/kg/day IV q12–24h {{and}} [[Vancomycin]] 10 mg/kg IV q6h
::::* Prefered regimen: [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO bid for 7-10 days
::*Alternate regimen (1): [[Levofloxacin]] 500 mg IV q24h (or 8 mg/kg IV q12h) {{and}} [[Clindamycin]] 20–40 mg/kg/day IV q6–8h
::::* Alternative regimen (1) (for patients who are allergic to or intolerant of TMP-SMX): [[Pyrimethamine]] 50-75 mg/day PO qd or divided in 2 equal doses {{and}} [[Leucovorin]] 10–25 mg PO qd
::::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg PO bid for 7 days (second-line alternative)
:::::* 1.1.1 '''In pregnancy'''
::::::* TMP-SMX should be avoided near-term because of the potential for hyperbilirubinemia and kernicterus in the newborn.
::::::* Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
:::::* 1.1.2 '''During lactation'''
::::::* TMP-SMX generally should be avoided by women when nursing infants who are premature, jaundiced, ill, or stressed, or who have glucose-6-phosphate dehydrogenase deficiency.
::::::* The American Academy of Pediatrics classifies Ciprofloxacin as usually compatible with breastfeeding, whereas the World Health Organization recommends avoiding Ciprofloxacin while breastfeeding and CDC recommends Ciprofloxacin should be used during lactation only if the potential benefit justifies the potential risk to the fetus.
:::::* 1.1.3 '''In pediatric patients'''
::::::* The use of TMP-SMX in children less than 2 months of age generally is not recommended.
::::::* Available evidence is conflicting regarding the potential for growth defects and arthropathies in exposed children. Use of ciprofloxacin in children requires assessment of potential risks and benefits.


::* 1.2 '''Immunocompromised hosts'''
:*Adults
:::* Preferred regimen (1): [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO/IV qid for 10 days
::*Preferred regimen (1): [[Cefotaxime]] 2 g IV q4–8h
:::* Preferred regimen (2): [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO/IV bid for 7-10 days
::*Preferred regimen (2): [[Ceftriaxone]] 1–2 g/day IV q12–24h {{and}} [[Vancomycin]] 2 g/day IV q6–12h
:::* Note (1): One approach is to start with TMP-SMX (160 mg/800 mg) bid regimen first, and increase daily dose and/or duration (up to 3–4 weeks) if symptoms worsen or persist.
::*Alternate regimen (1): [[Levofloxacin]] 750 mg IV q24h {{and}} [[Clindamycin]] 600–1200 mg IV q6–12h
:::* Note (2): IV therapy is recommended for patients with potential or documented malabsorption.
:::* Alternative regimen (1): [[Pyrimethamine]] 50–75 mg PO qd {{and}} [[Leucovorin]] 10–25 mg PO qd
:::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg PO bid for 7 days


:* 2. '''Cystoisospora belli prophylaxis'''<ref>{{cite web | title = Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents | url = https://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf }}</ref>
===Jugular vein phlebitis===
::* 2.1 '''Primary prophylaxis'''
* '''Septic jugular thrombophlebitis (Lemierre's syndrome)'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref>
:::* Insufficient evidence is available to support a general recommendation for primary prophylaxis for Cystoisosporiasis per se, especially for U.S. travelers in isoporiasis-endemic areas.
:* Causative pathogens
::* 2.2 '''Secondary prophylaxis (preventing recurrence in patients with CD4 count < 200 cells/mm<sup>3</sup>)'''
::* Fusobacterium
:::* Prefered regimen: [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO 3 times weekly
::* Viridans and other streptococci
:::* Alternative regimen (1): [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO qd
::* Staphylococcus
:::* Alternative regimen (2): [[Trimethoprim-sulfamethoxazole]] 320 mg/1600 mg PO 3 times weekly
::* Peptostreptococcus
:::* Alternative regimen (3): [[Pyrimethamine]] 25 mg PO qd {{and}} [[Leucovorin]] 5–10 mg PO qd
::* Bacteroides
:::* Alternative regimen (4): [[Ciprofloxacin]] 500 mg PO 3 times weekly (second-line alternative)
::* Other oral anaerobes
:::* Note (1): Criteria for discontinuation of chronic maintenance therapy: sustained increase in CD4 count > 200 cells/mm<sup>3</sup> for > 6 months in response to ART and without evidence of active Cystoisospora belli infection
:* Preferred regimen (immunocompetent host) (1): [[Penicillin G]] 2–4 MU IV q4–6h
:::* Note (2): Because of concerns about possible teratogenicity associated with first-trimester drug exposure, clinicians may withhold secondary prophylaxis during the first trimester and treat only symptomatic infection.
:* Preferred regimen (immunocompetent host) (2): [[Metronidazole]] 0.5 g IV q6h)
:* Preferred regimen (immunocompetent host) (3): [[Ampicillin-Sulbactam]] 2 g IV q4h
:* Preferred regimen (immunocompetent host) (4): [[Clindamycin]] 600 mg IV q6h
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h
:* Preferred regimen (immunocomppromised host) (5): [[Imipenem]] 500 mg IV q6h
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 400 mg IV q24h


----
===Laryngitis===
* Antibiotic use is not associated with significant improvement of objective symptoms<ref name="Reveiz-2005">{{Cite journal  | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | last3 = Ospina | first3 = EG. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume =  | issue = 1 | pages = CD004783 | month =  | year = 2005 | doi = 10.1002/14651858.CD004783.pub2 | PMID = 15674965 }}</ref><ref name="Reveiz-2007">{{Cite journal  | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | last3 = Ospina | first3 = EG. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume =  | issue = 2 | pages = CD004783 | month =  | year = 2007 | doi = 10.1002/14651858.CD004783.pub3 | PMID = 17443555 }}</ref><ref name="Reveiz-2013">{{Cite journal  | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume = 3 | issue =  | pages = CD004783 | month =  | year = 2013 | doi = 10.1002/14651858.CD004783.pub4 | PMID = 23543536 }}</ref> and is not indicated in the treatment of acute laryngitis.<ref name="Schwartz-2009">{{Cite journal  | last1 = Schwartz | first1 = SR. | last2 = Cohen | first2 = SM. | last3 = Dailey | first3 = SH. | last4 = Rosenfeld | first4 = RM. | last5 = Deutsch | first5 = ES. | last6 = Gillespie | first6 = MB. | last7 = Granieri | first7 = E. | last8 = Hapner | first8 = ER. | last9 = Kimball | first9 = CE. | title = Clinical practice guideline: hoarseness (dysphonia). | journal = Otolaryngol Head Neck Surg | volume = 141 | issue = 3 Suppl 2 | pages = S1-S31 | month = Sep | year = 2009 | doi = 10.1016/j.otohns.2009.06.744 | PMID = 19729111 }}</ref>


===Lemierre's syndrome===
* '''Septic jugular thrombophlebitis (Lemierre's syndrome)'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref>
:* Causative pathogens
::* Fusobacterium
::* Viridans and other streptococci
::* Staphylococcus
::* Peptostreptococcus
::* Bacteroides
::* Other oral anaerobes
:* Preferred regimen (immunocompetent host) (1): ([[Penicillin G]] 2–4 MU IV q4–6h {{and}} [[Metronidazole]] 0.5 g IV q6h)
:* Preferred regimen (immunocompetent host) (2): [[Ampicillin-Sulbactam]] 2 g IV q4h
:* Preferred regimen (immunocompetent host) (3): [[Clindamycin]] 600 mg IV q6h
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h
:* Preferred regimen (immunocomppromised host) (5): [[Imipenem]] 500 mg IV q6h
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 400 mg IV q24h


:*'''Immunocompetent'''<ref name=CDC Parasites - Cystoisosporiasis>{{cite web | title = CDC - Cystoisosporiasis| url = http://www.cdc.gov/parasites/cystoisospora/health_professionals/index.html }}</ref>
===Ludwig's angina===
::* Prefered regimen: [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO {{or}} IV qid for 10 days
* '''Ludwig's angina'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref>
:* Causative pathogens
::* Viridans and other streptococci
::* Peptostreptococcus
::* Bacteroides
::* Other oral anaerobes
:* Preferred regimen (immunocompetent host) (1): ([[Penicillin G]] 2–4 MU IV q4–6h {{and}} [[Tobramycin]] 2 mg/kg IV q8h)
:* Preferred regimen (immunocompetent host) (2): [[Ampicillin-Sulbactam]] 2 g IV q4h
:* Preferred regimen (immunocompetent host) (3): [[Clindamycin]] 600 mg IV q6h
:* Preferred regimen (immunocompetent host) (4): [[Doxycycline]] 200 mg IV q12h
:* Preferred regimen (immunocompetent host) (5): [[Cefoxitin]] 2 g IV q6h
:* Preferred regimen (immunocompetent host) (6): [[Cefotetan]] 2 g IV q12h
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h
:* Preferred regimen (immunocomppromised host) (5): [[Meropenem]] 1 g IV q8h
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 200 mg IV q24h


::* '''1. Patients with sulfa intolerance'''
===Parapharyngeal space infection===
:::* Alternative regimen (1): [[Pyrimethamine]] 50-75 mg PO daily {{and}} Leucovorin 10–25 mg PO daily
* '''Parapharyngeal space infection'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref>
:::* Alternative regimen (2): [[Ciprofloxacin]] 500 mg PO BID for 7 days
:* Causative pathogens
::* Viridans and other streptococci
::* Staphylococcus
::* Peptostreptococcus
::* Bacteroides
::* Other oral anaerobes
:* Preferred regimen (immunocompetent host) (1): ([[Penicillin G]] 2–4 MU IV q4–6h {{and}} [[Metronidazole]] 0.5 g IV q6h)
:* Preferred regimen (immunocompetent host) (2): [[Ampicillin-Sulbactam]] 2 g IV q4h
:* Preferred regimen (immunocompetent host) (3): [[Clindamycin]] 600 mg IV q6h
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h
:* Preferred regimen (immunocomppromised host) (5): [[Imipenem]] 500 mg IV q6h
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 400 mg IV q24h


===Pharyngitis, diphtheria===
*Diphtheria<ref>''The first version of this article was adapted from the [[Centers for Disease Control and Prevention|CDC]] document "Diphtheria - 1995 Case Definition" athttp://www.cdc.gov/epo/dphsi/casedef/diphtheria_current.htm. As a work of an agency of the U.S. Government without any other copyright notice it should be available as a public domain resource''.</ref>
:*The CDC recommends either:
::*Preferred regimen (1): [[Erythromycin]] (PO or by IV) for 14 days (40 mg/kg per day with a maximum of 2 g/d)
::*Preferred regimen (2): [[Procaine penicillin G]] given IM for 14 days (300,000 U/d for patients weighing <10 kg and 600,000 U/d for those weighing >10 kg).
:*Patients with allergies
::*Preferred regimen (1): [[Penicillin G]]
::*Preferred regimen (2): [[Erythromycin]]
::*Preferred regimen (3): [[Eifampin]]
::*Preferred regimen (4): [[Clindamycin]]


===Pharyngitis, streptococcal===
*Pharyngitis <ref name="Thomas-2000">{{Cite journal  | last1 = Thomas | first1 = M. | last2 = Del Mar | first2 = C. | last3 = Glasziou | first3 = P. | title = How effective are treatments other than antibiotics for acute sore throat? | journal = Br J Gen Pract | volume = 50 | issue = 459 | pages = 817-20 | month = Oct | year = 2000 | doi =  | PMID = 11127175 }}</ref><ref name="Spinks-2013">{{Cite journal  | last1 = Spinks | first1 = A. | last2 = Glasziou | first2 = PP. | last3 = Del Mar | first3 = CB. | title = Antibiotics for sore throat. | journal = Cochrane Database Syst Rev | volume = 11 | issue =  | pages = CD000023 | month =  | year = 2013 | doi = 10.1002/14651858.CD000023.pub4 | PMID = 24190439 }}</ref>
:*Acute
::*Children:
*Preferred regimen: [[Pencillin V]] PO 250 mg twice daily or 3 times daily 
::*Adolescents and adults:
*Preferred regimen (1): [[Pencillin V]] PO 250 mg 4 times daily or 500 mg twice daily for 10 days
*Preferred regimen (2): [[Amoxicillin]] 50 mg/kg once daily (max = 1000 mg) alternate:25 mg/kg (max = 500 mg) twice daily for 10 days
*Preferred regimen (3): [[Penicillin G|Benzathine Penicillin G]] I.M 27 kg: 600 000 U; ≥27 kg: 1 200 000 U 1 dose only
*Preferred regimen (4): [[Cephalexin]] PO 20 mg/kg/dose twice daily (max = 500 mg/dose)for 10 days
*Alternate regimen (1): [[Cefadroxil]] PO 30 mg/kg OD (max = 1 g) for 10 days
*Alternate regimen (2): [[Clindamycin]] PO 7 mg/kg/dose 3 times daily (max = 300 mg/dose) for 10 days
*Alternate regimen (3): [[Azithromycin]]PO 12 mg/kg once daily (max = 500 mg) for 5 days
*Alternate regimen (4): [[Clarithromycin]] PO 7.5 mg/kg/dose twice daily (max = 250 mg/dose) for 10 days
:*Chronic
::*Preferred regimen (1): [[Clindamycin]] 20–30 mg/kg/d in 3 doses (max = 300 mg/dose) for 10 days
::*Preferred regimen (2): [[Penicillin]] {{and}} [[Rifampin]]; Penicillin V: 50 mg/kg/d in 4 doses × 10 d (max = 2000 mg/d) ;rifampin: 20 mg/kg/d in 1 dose × last 4 d of treatment (max = 600 mg/d) for 10 days {{and}} [[Amoxicillin–clavulanate]] 40 mg amoxicillin/kg/d in 3 doses (max = 2000 mg amoxicillin/d) for 10 days
::*Preferred regimen (3): [[Benzathine penicillin G]] IM 600 000 U for <27 kg and 1 200 000 U for ≥27 kg single dose {{and}} [[Rifampin]] PO 20 mg/kg/d in 2 doses (max = 600 mg/d) for 4 days


:*'''HIV'''
===Sinusitis, Acute===
::*'''1. Patients with CD4 Count <200/mm3 (chronic treatment)'''
*Sinusitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* Prefered regimen: [[Trimethoprim-sulfamethoxazole]] 160 mg/800 mg PO 3 times weekly
:::* Alternative regimen (1): [[Trimethoprim-sulfamethoxazole]] 320 mg/1600 mg PO 3 times weekly
:::* Alternative regimen (2): [[Pyrimethamine]] 25 mg PO daily {{and}} [[Leucovorin]] 5–10 mg PO daily 
:::* Alternative regimen (3): [[Ciprofloxacin]] 500 mg PO 3 times weekly


*Sinusitis (Pediatrics)
:*Preferred Regimen (1): [[Amoxicillin]] 90 mg / kg / day PO divided q12h
:*Preferred Regimen (2): [[Amoxicillin-clavulanate]] (extra strength) suspension, 90 mg / kg / day (based on Amox component), PO divided q12h for 10-14 days
::*If  non-type I hypersensitivity to penicillin :
:::*Preferred regimen (1): [[Cefuroxime axetil]] 30 mg / kg / day PO divided q12h for 10-14 days
:::*Alternate Regimen (1): [[Cefdinir]] 14 mg / kg / day PO divided q12-24h, max of 600 mg / day for 10-14 days
:::*Alternate Regimen (2):  [[Cefpodoxime]] 10 mg / kg / day PO divided q12h for 10-14 days
*Sinusitis (Adults)
:*Preferred Regimen (1): [[Amoxicillin]] 250-500 mg  q8h or 500-875 mg q12h or extended-release tablet 775 mg once daily
:*Preferred Regimen (2): [[Amoxicillin-clavulanate]] (extended release tabs) 1000 / 62.5 mg 2 tabs or 2000/125 mg 1 tab, PO q12h for 5-7 days
:*Alternate Regimen 
::*If type 1 hypersensitivity to penicillin :
:*Preferred regimen (1): [[Levofloxacin]] 750 mg PO once daily for 5-7 days
:*Preferred regimen (2): [[Doxycycline]] 100 mg PO q12h for 5-7 days
::*If type 2 hypersensitivity to penicillin :
:*Preferred regimen (1): [[Cefdinir]] 600 mg / day divided q12h or q24h for 5-7 days
:*Preferred regimen (2): [[Cefpodoxime]] 200 mg PO q12h for 5-7 days
:*Preferred regimen (3): [[Cefuroxime axetil]] 500 mg PO q12h for 5-7 days
===Sinusitis, Chronic===
*Sinusitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
*Sinusitis (Pediatrics)
:*Preferred Regimen:[[Amoxicillin-clavulanate]] 45 mg/kg per day q12h
:*If penicillin allergy and patient is MRSA positive
::*[[Clindamycin]] 20 to 40 mg/kg per day orally divided every 6 to 8 hours
:*If anaerobes are involved
::*[[Metronidazole]] PLUS one of the following: [[cefuroxime axetil]], [[cefdinir]], [[cefpodoxime proxetil]],[[azithromycin]], [[clarithromycin]], or [[trimethoprim-sulfamethoxazole]] (TMP-SMX)
*Sinusitis (Adults)
:*Preferred regimen (1): [[Amoxicillin-clavulanate]] 500 mg three times daily
:*Preferred regimen (2): [[Amoxicillin-clavulanate]] 875 mg twice daily
:*Preferred regimen (3): [[Amoxicillin-clavulanate]] two 1000 mg extended-release tablets twice daily)
:*If penicillin allergy and patient is MRSA positive
:*Preferred regimen (1): [[Clindamycin]] 300 mg four times daily or 450 mg three times daily)
:*If anaerobes are involved
:*Preferred regimen (1):[[Metronidazole]] {{and}} one of the following: [[cefuroxime axetil]], [[cefdinir]], [[cefpodoxime proxetil]], [[levofloxacin]] , [[azithromycin]], [[clarithromycin]]
:*Preferred regimen (2): [[trimethoprim-sulfamethoxazole]] (TMP-SMX)
:*Alternate regimen: [[Moxifloxacin ]](400 mg once daily)
===Sinusitis, post-intubation===
*Sinusitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*Preferred regimen (1): [[Imipenem]] 0.5 gm IV q6h
:*Preferred regimen (2): [[Meropenem]] 1 gm IV q8h,  MRSA suggestive on Gram - stain then add [[Vancomycin]] 1 gm IV q12h
:*Alternate Regimen (1): [[Ceftazidime]] 2 gm IV q8h {{and}} [[Vancomycin]] 1 gm IV q12h)
:*Alternate Regimen (2): [[Cefepime]] 2 gm IV q12h {{and}} [[Vancomycin]] 1 gm IV q12h)
===Sinusitis, treatment failure===
*Sinusitis (Pediatrics)  <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*If treatment failure then do a culture and treat accordingly or treatment in the absence of cultures and children failing [[Amoxicillin]]
::*[[Amoxicillin-clavulanate]] (extra strength) suspension 90 mg/kg/day (Amoxicllin component) PO divided q12h for 10-14 days.
:*Treatment in the absence of cultures and children failing [[Amoxicillin-clavulanate]]
::*[[Clindamycin]] 30-40 mg/kg/day divided q8h {{and}} third generation [[cephalosporin]] like [[Cefuroxime axetil]] 30 mg/kg/day PO divided q12h
Preferred regimen (1):  [[Cefdinir]] 14 mg/kg/day PO divided q12h or q24h
Preferred regimen (2):[[Cefpodoxime]] 10 mg/kg/day PO divided q12h
*Sinusitis (Adults)
:*If failure of treatment  even after 7 days of diagnosis
Preferred regimen (1): [[Amoxicillin-clavulanate]] 4g per day of amoxicillin equivalent
Preferred regimen (2): [[Levofloxacin]] 500 mg PO once daily
Preferred regimen (3): [[Moxifloxacin]]400 mg PO once daily
===Stomatitis, aphthous===
*Stomatitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*[[Topical steroids]] may decrease pain and swelling
===Stomatitis, herpetic===
*Stomatitis  <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*[[Acyclovir]] 15 mg/kg PO q5h For 7 days
===Submandibular space infection===
* '''Submandibular space infections including Ludwig angina'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref>
:* Causative pathogens
::* Viridans and other streptococci
::* Peptostreptococcus
::* Bacteroides
::* Other oral anaerobes
:* Preferred regimen (immunocompetent host) (1): [[Penicillin G]] 2–4 MU IV q4–6h {{and}} [[Tobramycin]] 2 mg/kg IV q8h)
:* Preferred regimen (immunocompetent host) (2): [[Ampicillin-Sulbactam]] 2 g IV q4h
:* Preferred regimen (immunocompetent host) (3): [[Clindamycin]] 600 mg IV q6h
:* Preferred regimen (immunocompetent host) (4): [[Doxycycline]] 200 mg IV q12h
:* Preferred regimen (immunocompetent host) (5): [[Cefoxitin]] 2 g IV q6h
:* Preferred regimen (immunocompetent host) (6): [[Cefotetan]] 2 g IV q12h
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h
:* Preferred regimen (immunocomppromised host) (5): [[Meropenem]] 1 g IV q8h
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 200 mg IV q24h
===Tonsillitis===
*Tonsillitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*Preferred regimen:[[Penicillin V]] PO 10 days or if compliance unlikely, [[Benzathine penicillin]] IM single dose
:*Alternate regimen (1): [[Cephalosporins|2nd generation Cephalosporins]] PO for 4–6 days
:*Alternate regimen (2): [[Clindamycin]] or [[azithromycin]] for 5 days
:*Alternate regimen (3): [[Clarithromycin]] for 10 days
:*Alternate regimen (4): [[Erythromycin]] for 10 days. Extended-release [[amoxicillin]] is another (expensive) option
===Ulcerative gingivitis===
*Provide patient with specific oral hygiene instructions to use a prescription antibacterial mouthwash: [[Chlorhexidine]] 0.12% twice daily.<ref>{{Cite web | title =Managing Patients with Necrotizing Ulcerative Gingivitis
| url = http://www.jcda.ca/article/d46}}</ref>
*For any signs of systemic involvement, the recommended antibiotics are:
:*Preferred regimen: [[Amoxicillin]], 250 mg 3 x daily for 7 days {{withorwithout}} [[Metronidazole]], 250 mg 3 x daily for 7 days
===Vincent's angina===
*Vincent's angina  <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:*Preferred treatment:[[Penicillin G]] 4 million units IV q4h
:*Alternate treatment: [[Clindamycin]] 600 mg IV q8h


==References==
{{reflist}}
{{reflist}}

Latest revision as of 18:00, 30 July 2015

Epiglottitis

  • Epiglottitis [1]
  • Pediatrics
  • Adults

Jugular vein phlebitis

  • Septic jugular thrombophlebitis (Lemierre's syndrome)[2]
  • Causative pathogens
  • Fusobacterium
  • Viridans and other streptococci
  • Staphylococcus
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • Preferred regimen (immunocompetent host) (1): Penicillin G 2–4 MU IV q4–6h
  • Preferred regimen (immunocompetent host) (2): Metronidazole 0.5 g IV q6h)
  • Preferred regimen (immunocompetent host) (3): Ampicillin-Sulbactam 2 g IV q4h
  • Preferred regimen (immunocompetent host) (4): Clindamycin 600 mg IV q6h
  • Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
  • Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
  • Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
  • Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
  • Preferred regimen (immunocomppromised host) (5): Imipenem 500 mg IV q6h
  • Preferred regimen (immunocomppromised host) (6): Gatifloxacin 400 mg IV q24h

Laryngitis

  • Antibiotic use is not associated with significant improvement of objective symptoms[3][4][5] and is not indicated in the treatment of acute laryngitis.[6]

Lemierre's syndrome

  • Septic jugular thrombophlebitis (Lemierre's syndrome)[7]
  • Causative pathogens
  • Fusobacterium
  • Viridans and other streptococci
  • Staphylococcus
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • Preferred regimen (immunocompetent host) (1): (Penicillin G 2–4 MU IV q4–6h AND Metronidazole 0.5 g IV q6h)
  • Preferred regimen (immunocompetent host) (2): Ampicillin-Sulbactam 2 g IV q4h
  • Preferred regimen (immunocompetent host) (3): Clindamycin 600 mg IV q6h
  • Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
  • Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
  • Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
  • Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
  • Preferred regimen (immunocomppromised host) (5): Imipenem 500 mg IV q6h
  • Preferred regimen (immunocomppromised host) (6): Gatifloxacin 400 mg IV q24h

Ludwig's angina

  • Ludwig's angina[8]
  • Causative pathogens
  • Viridans and other streptococci
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • Preferred regimen (immunocompetent host) (1): (Penicillin G 2–4 MU IV q4–6h AND Tobramycin 2 mg/kg IV q8h)
  • Preferred regimen (immunocompetent host) (2): Ampicillin-Sulbactam 2 g IV q4h
  • Preferred regimen (immunocompetent host) (3): Clindamycin 600 mg IV q6h
  • Preferred regimen (immunocompetent host) (4): Doxycycline 200 mg IV q12h
  • Preferred regimen (immunocompetent host) (5): Cefoxitin 2 g IV q6h
  • Preferred regimen (immunocompetent host) (6): Cefotetan 2 g IV q12h
  • Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
  • Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
  • Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
  • Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
  • Preferred regimen (immunocomppromised host) (5): Meropenem 1 g IV q8h
  • Preferred regimen (immunocomppromised host) (6): Gatifloxacin 200 mg IV q24h

Parapharyngeal space infection

  • Parapharyngeal space infection[9]
  • Causative pathogens
  • Viridans and other streptococci
  • Staphylococcus
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • Preferred regimen (immunocompetent host) (1): (Penicillin G 2–4 MU IV q4–6h AND Metronidazole 0.5 g IV q6h)
  • Preferred regimen (immunocompetent host) (2): Ampicillin-Sulbactam 2 g IV q4h
  • Preferred regimen (immunocompetent host) (3): Clindamycin 600 mg IV q6h
  • Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
  • Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
  • Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
  • Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
  • Preferred regimen (immunocomppromised host) (5): Imipenem 500 mg IV q6h
  • Preferred regimen (immunocomppromised host) (6): Gatifloxacin 400 mg IV q24h

Pharyngitis, diphtheria

  • The CDC recommends either:
  • Preferred regimen (1): Erythromycin (PO or by IV) for 14 days (40 mg/kg per day with a maximum of 2 g/d)
  • Preferred regimen (2): Procaine penicillin G given IM for 14 days (300,000 U/d for patients weighing <10 kg and 600,000 U/d for those weighing >10 kg).
  • Patients with allergies

Pharyngitis, streptococcal

  • Acute
  • Children:
  • Preferred regimen: Pencillin V PO 250 mg twice daily or 3 times daily
  • Adolescents and adults:
  • Preferred regimen (1): Pencillin V PO 250 mg 4 times daily or 500 mg twice daily for 10 days
  • Preferred regimen (2): Amoxicillin 50 mg/kg once daily (max = 1000 mg) alternate:25 mg/kg (max = 500 mg) twice daily for 10 days
  • Preferred regimen (3): Benzathine Penicillin G I.M 27 kg: 600 000 U; ≥27 kg: 1 200 000 U 1 dose only
  • Preferred regimen (4): Cephalexin PO 20 mg/kg/dose twice daily (max = 500 mg/dose)for 10 days
  • Alternate regimen (1): Cefadroxil PO 30 mg/kg OD (max = 1 g) for 10 days
  • Alternate regimen (2): Clindamycin PO 7 mg/kg/dose 3 times daily (max = 300 mg/dose) for 10 days
  • Alternate regimen (3): AzithromycinPO 12 mg/kg once daily (max = 500 mg) for 5 days
  • Alternate regimen (4): Clarithromycin PO 7.5 mg/kg/dose twice daily (max = 250 mg/dose) for 10 days
  • Chronic
  • Preferred regimen (1): Clindamycin 20–30 mg/kg/d in 3 doses (max = 300 mg/dose) for 10 days
  • Preferred regimen (2): Penicillin AND Rifampin; Penicillin V: 50 mg/kg/d in 4 doses × 10 d (max = 2000 mg/d) ;rifampin: 20 mg/kg/d in 1 dose × last 4 d of treatment (max = 600 mg/d) for 10 days AND Amoxicillin–clavulanate 40 mg amoxicillin/kg/d in 3 doses (max = 2000 mg amoxicillin/d) for 10 days
  • Preferred regimen (3): Benzathine penicillin G IM 600 000 U for <27 kg and 1 200 000 U for ≥27 kg single dose AND Rifampin PO 20 mg/kg/d in 2 doses (max = 600 mg/d) for 4 days

Sinusitis, Acute

  • Sinusitis (Pediatrics)
  • Preferred Regimen (1): Amoxicillin 90 mg / kg / day PO divided q12h
  • Preferred Regimen (2): Amoxicillin-clavulanate (extra strength) suspension, 90 mg / kg / day (based on Amox component), PO divided q12h for 10-14 days
  • If non-type I hypersensitivity to penicillin :
  • Preferred regimen (1): Cefuroxime axetil 30 mg / kg / day PO divided q12h for 10-14 days
  • Alternate Regimen (1): Cefdinir 14 mg / kg / day PO divided q12-24h, max of 600 mg / day for 10-14 days
  • Alternate Regimen (2): Cefpodoxime 10 mg / kg / day PO divided q12h for 10-14 days
  • Sinusitis (Adults)
  • Preferred Regimen (1): Amoxicillin 250-500 mg q8h or 500-875 mg q12h or extended-release tablet 775 mg once daily
  • Preferred Regimen (2): Amoxicillin-clavulanate (extended release tabs) 1000 / 62.5 mg 2 tabs or 2000/125 mg 1 tab, PO q12h for 5-7 days
  • Alternate Regimen
  • If type 1 hypersensitivity to penicillin :
  • Preferred regimen (1): Levofloxacin 750 mg PO once daily for 5-7 days
  • Preferred regimen (2): Doxycycline 100 mg PO q12h for 5-7 days
  • If type 2 hypersensitivity to penicillin :
  • Preferred regimen (1): Cefdinir 600 mg / day divided q12h or q24h for 5-7 days
  • Preferred regimen (2): Cefpodoxime 200 mg PO q12h for 5-7 days
  • Preferred regimen (3): Cefuroxime axetil 500 mg PO q12h for 5-7 days

Sinusitis, Chronic

  • Sinusitis (Pediatrics)
  • Clindamycin 20 to 40 mg/kg per day orally divided every 6 to 8 hours
  • If anaerobes are involved
  • Sinusitis (Adults)

Sinusitis, post-intubation

Sinusitis, treatment failure

  • Sinusitis (Pediatrics) [16]
  • If treatment failure then do a culture and treat accordingly or treatment in the absence of cultures and children failing Amoxicillin
  • Amoxicillin-clavulanate (extra strength) suspension 90 mg/kg/day (Amoxicllin component) PO divided q12h for 10-14 days.

Preferred regimen (1): Cefdinir 14 mg/kg/day PO divided q12h or q24h Preferred regimen (2):Cefpodoxime 10 mg/kg/day PO divided q12h

  • Sinusitis (Adults)
  • If failure of treatment even after 7 days of diagnosis

Preferred regimen (1): Amoxicillin-clavulanate 4g per day of amoxicillin equivalent Preferred regimen (2): Levofloxacin 500 mg PO once daily Preferred regimen (3): Moxifloxacin400 mg PO once daily

Stomatitis, aphthous

Stomatitis, herpetic

Submandibular space infection

  • Submandibular space infections including Ludwig angina[19]
  • Causative pathogens
  • Viridans and other streptococci
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • Preferred regimen (immunocompetent host) (1): Penicillin G 2–4 MU IV q4–6h AND Tobramycin 2 mg/kg IV q8h)
  • Preferred regimen (immunocompetent host) (2): Ampicillin-Sulbactam 2 g IV q4h
  • Preferred regimen (immunocompetent host) (3): Clindamycin 600 mg IV q6h
  • Preferred regimen (immunocompetent host) (4): Doxycycline 200 mg IV q12h
  • Preferred regimen (immunocompetent host) (5): Cefoxitin 2 g IV q6h
  • Preferred regimen (immunocompetent host) (6): Cefotetan 2 g IV q12h
  • Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
  • Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
  • Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
  • Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
  • Preferred regimen (immunocomppromised host) (5): Meropenem 1 g IV q8h
  • Preferred regimen (immunocomppromised host) (6): Gatifloxacin 200 mg IV q24h

Tonsillitis

Ulcerative gingivitis

  • Provide patient with specific oral hygiene instructions to use a prescription antibacterial mouthwash: Chlorhexidine 0.12% twice daily.[21]
  • For any signs of systemic involvement, the recommended antibiotics are:

Vincent's angina

  • Vincent's angina [22]
  1. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  2. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  3. ↑ Reveiz, L.; Cardona, AF.; Ospina, EG. (2005). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev (1): CD004783. doi:10.1002/14651858.CD004783.pub2. PMID 15674965.
  4. ↑ Reveiz, L.; Cardona, AF.; Ospina, EG. (2007). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev (2): CD004783. doi:10.1002/14651858.CD004783.pub3. PMID 17443555.
  5. ↑ Reveiz, L.; Cardona, AF. (2013). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev. 3: CD004783. doi:10.1002/14651858.CD004783.pub4. PMID 23543536.
  6. ↑ Schwartz, SR.; Cohen, SM.; Dailey, SH.; Rosenfeld, RM.; Deutsch, ES.; Gillespie, MB.; Granieri, E.; Hapner, ER.; Kimball, CE. (2009). "Clinical practice guideline: hoarseness (dysphonia)". Otolaryngol Head Neck Surg. 141 (3 Suppl 2): S1–S31. doi:10.1016/j.otohns.2009.06.744. PMID 19729111. Unknown parameter |month= ignored (help)
  7. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  8. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  9. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  10. ↑ The first version of this article was adapted from the CDC document "Diphtheria - 1995 Case Definition" athttp://www.cdc.gov/epo/dphsi/casedef/diphtheria_current.htm. As a work of an agency of the U.S. Government without any other copyright notice it should be available as a public domain resource.
  11. ↑ Thomas, M.; Del Mar, C.; Glasziou, P. (2000). "How effective are treatments other than antibiotics for acute sore throat?". Br J Gen Pract. 50 (459): 817–20. PMID 11127175. Unknown parameter |month= ignored (help)
  12. ↑ Spinks, A.; Glasziou, PP.; Del Mar, CB. (2013). "Antibiotics for sore throat". Cochrane Database Syst Rev. 11: CD000023. doi:10.1002/14651858.CD000023.pub4. PMID 24190439.
  13. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  14. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  15. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  16. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  17. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  18. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  19. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  20. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  21. ↑ "Managing Patients with Necrotizing Ulcerative Gingivitis".
  22. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
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